ultrasound features associated with prenatally diagnosed klinefelter syndrome

injections to be performed under real-time guidance, further assistingpatient management.

Musculoskeletal inflammation and traumaJacobson JA, Radiology, University of Michigan, Ann Arbor, MI

Sonographic evaluation of musculoskeletal inflammation and trauma istypically focused over an area of abnormal signs, symptoms, or phys-ical examination findings. It is important to not only evaluate thesuperficial structures with a high-frequency transducer (10 MHz orgreater), but also evaluate deeper structures with a lower frequencytransducer. This will ensure a thorough and global examination. Oncean abnormality is identified, determining accurate location, such asjoint recess, muscle belly, musculotendinous junction, or subcutaneoustissues, will often limit the differential diagnosis. Another advantage ofsonography that should always be considered is dynamic imaging. Thiscan help differentiate hypoechoic abscess from myositis as the priormay show swirling of internal contents. With respect to joint fluid andtenosynovitis, complicated fluid and synovium may both appear hypo-echoic. Compressibility and displacement with transducer pressureindicating complex fluid are helpful in this differentiation. In the settingof tendon trauma, it is critical to distinguish between partial-thicknessand full-thickness tear. Identification of tendon retraction indicatesfull-thickness tear. This becomes more conspicuous with dynamicimaging. Lack of tendon translation through a tear with extremitymovement or muscle palpation indicates complete tendon tear. Lastly,tendon or nerve subluxation may only be present during dynamicimaging. It is also valuable to use patient feedback during scanning. Ifa patient indicates a focal symptomatic area, this will likely yieldpathology. When an abnormality is detected, it is important to deter-mine if the symptoms are reproduced with transducer pressure toindicate the inciting pathology has been detected.

POSTER EXHIBITS

POSTER SESSION

17157

Ultrasound features associated with prenatally diagnosedKlinefelter syndromeWax J,* Pinette MG, Blackstone J, Cartin A, Division of Maternal-Fetal Medicine, Maine Medical Center, Portland, ME

Objective: The aim of this study was to describe first- and second-trimester sonographic findings in fetuses prenatally diagnosed withKlinefelter syndrome.Methods: We searched our perinatal database for all cases of prena-tally diagnosed Klinefelter syndrome. Ultrasound reports and imageswere reviewed for aneuploidy markers and anomalies.Results: Six fetuses were diagnosed by amniocentesis of whom 3(50%) exhibited sonographic abnormalities. Case 1: The fetus of a40-year-old woman had an increased nuchal translucency of 3.2 mm at14 weeks’ gestation. Amniocyte karyotype was 47,XXY. At 18 weeks,the observed/expected femur length was short, 0.88. Case 2: At 21weeks’ gestation, a 30-year-old woman underwent amniocentesis for afetus with a single left ventricular echogenic papillary muscle andbilateral hydronephrosis. The karyotype was 47,XXY. Case 3: A 44-year-old woman’s 13.4-week ultrasound showed an increased nuchaltranslucency of 4.2 mm. Other findings included a cystic placenta,decreased amniotic fluid volume, syndactyly, and echogenic bowel.Amniocentesis demonstrated the karyotype 48,XXY,�18.

Conclusions: Established first- and second-trimester aneuploidy mark-ers may be seen in up to half of prenatally diagnosed Klinefeltersyndrome cases. Genetic counseling before prenatal diagnosis shouldinclude a discussion of sex chromosome abnormalities.

17158

Childhood cardiac function after prenatal diagnosis ofintracardiac echogenic fociWax J,*1 Donnelly J,2 Carpenter M,1 Chard R,1 Cartin A,1 PinetteM,1 Blackstone J,1 1. Division of Maternal-Fetal Medicine, MaineMedical Center, Portland, ME, and 2. Pediatric Cardiology Assoc.,Maine Medical Center, Portland, ME

Objective: The aim of this study was to determine if prenatallydiagnosed intracardiac echogenic foci (ICEF) are associated with child-hood cardiac dysfunction.Methods: Children demonstrating an ICEF on prenatal ultrasound inone perinatal center underwent echocardiography at ages 2–7 years. Asingle pediatric cardiologist, blinded to the prenatal sonographic ICEFlocation, assessed cardiac function by measuring the left ventricularshortening fraction (LVSF) and myocardial performance index (MPI).The presence of tricuspid (TVR) and mitral valve regurgitation (MVR)was also sought. Secondary outcomes included ICEF persistence andthe presence of echobright endocardium as a surrogate for fibrosis.Results: 25 children, 14 (56%) male and 11 (44%) female, wereexamined at a mean age of 3.0 � 1.0 years. Prenatally, 18 (72%)subjects had left (LV) ICEF and 7 (28%) had right ventricular (RV)ICEF. While persistence was noted in 16 (89%) LV ICEF and 2 (29%)RV ICEF (p � 0.007), this likely represents technical difficulty invisualizing right ventricular papillary muscles and free wall. Cardiacfunction, echogenic endocardium, and incidence of false chords aredescribed in the table below. Comparisons were made between patientswith LV versus RV ICEF. There was no association between elevatedMPI and echogenic endocardium or false chords. No child exhibitedclinically significant cardiac dysfunction.Conclusions: Most prenatally recognized ICEF, especially left ventric-ular, persist into childhood. Prenatally diagnosed ICEF are not associ-ated with clinically significant childhood myocardial dysfunction.

Prenatal ICEF Location

LV (n � 18) RV (n � 7) Any (n � 25)LVSF mean � SD 38 � 4 39 � 5 38 � 4LVSF # normal (%) 18 (100) 7 (100) 25 (100)LV MPI mean � SD 0.36 � 0.06 0.36 � 0.04 0.36 � 0.06LV MPI # normal (%) 14 (78) 5 (71) 19 (76)TVR*# (%) 8 (44) 5 (71) 13 (52)MR*# (%) 2 (11) 0 (0) 2 (8)Echobright endocardium (%) 11 (61) 4 (57) 15 (60)False chord (%) 9 (50) 4 (57) 13 (52)

*Trace in all cases (all comparisons not statistically significant).

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The comparative study of high- and low-frequency ultrasoundtherapy on bone regenerationBashardoust Tajali S,* Kazemi S, Azari A, Shahverdi A, Jabal AmeliM, Physical Therapy, Iranian Academic Center for Education,Culture and Research (ACECR), Iran Medical Science Branch,Tehran, Tehran, Iran

Objective: In this research, the effects of ultrasound therapy with1-MHz and 3-MHz frequency were studied on bone regeneration inrabbits from biomechanical and histological points of view.Methods: 160 white male Dutch-Poland rabbits were operated onmedial open dental hole partial osteotomy (DHPO) of the tibia bone in

S120 Ultrasound in Medicine and Biology Volume 29, Number 5S, 2003